The African Union (AU) finished its annual summit last week with governments agreeing to make maternal and child mortality a continent-wide priority. The summit ended with Member States extending the controversial, non-binding Maputo Plan of Action (PoA) for an additional five years and expanding new initiative called the Campaign on Accelerated Reduction on Maternal Mortality in Africa (CARMMA).
Pressure was placed on the AU from UN agencies and foreign non-governmental organizations (NGO). While United Nations Population Fund (UNFPA) executive director Thoraya Obaid, called on delegates to focus on non-controversial interventions to reduce maternal deaths – such as skilled birth attendants and emergency obstetric care – the very next day in a speech at Makerere University in Kampala Obaid focused instead on “unsafe abortion,” “reproductive rights,” “reproductive health services” and “sexuality education.”
The pro-abortion NGO coalition told the AU assembly they were “ashamed” of Africa’s high maternal and child mortality. The NGOs called on governments for “guaranteed access to family planning services,” “reproductive health commodity security” and to address “unsafe abortion.” The NGO statement did not mention skilled birth attendants or emergency obstetric care, what are traditionally understood as the cures for high maternal mortality.
Abortion advocates have heralded the Maputo PoA as a victory for their cause since the document calls for “policies and legal frameworks to reduce incidence of unsafe abortion” and to “prepare and implement national plans of action to reduce incidence of unwanted pregnancies and unsafe abortion.” While the focus on maternal health is generally viewed as a positive development, critics warn that the warm feelings about reducing maternal mortality are being used also to promote a right to abortion.
Critics point to the sneaky way the Maputo document came into being. Prior to the 2006 passage of the PoA, several AU delegations objected to the abortion provisions and only agreed to the document on the understanding that the abortion clauses would be removed. The changes were never made and several African nations charged the AU secretariat with “manipulation.”
Originally intended to be a short-term three-year plan, the AU decision will extend the Maputo PoA through 2015, to coincide with the planned conclusion of the Millennium Development Goals (MDGs).
In addition to extending the PoA, AU member states committed to expanding CARMMA, an initiative to promote “intensified action” on MDG 5 maternal health. Since the initial launch in May 2009, CARMMA has since been launched in 20 countries. Last week, AU members committed to ensuring that CARMMA would be launched in all 53 African countries before the next AU summit.
In addition to renewing the Maputo PoA and expanding CARMMA, AU member states also committed to increasing health funding to 15% of national budgets, making health services free for women and children and called on donor nations to fulfill their pledges.
Such funding became a major part of the conference negotiations. While participants praised the recent $7.3 billion pledged by the G-8 for maternal health, delegates said much more was needed. Some proposed additional money could be siphoned off from the Global Fund to Fight AIDS, Tuberculosis and Malaria though this was not acted upon.